Provider Demographics
NPI:1942075643
Name:COOK, LEAH NICOLE (RN-BSN)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:NICOLE
Last Name:COOK
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 ARNEY ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3926
Mailing Address - Country:US
Mailing Address - Phone:704-530-0657
Mailing Address - Fax:
Practice Address - Street 1:2111 ARNEY ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3926
Practice Address - Country:US
Practice Address - Phone:704-530-0657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC344536163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse